Analysis of Spatial and Temporal Patterns in Deaths of Despair in the Appalachian Region of the United States

Mortality data in the United States (U.S.) revealed a precipitous rise in deaths among non-Hispanic white populations starting in the later part of 1990s due to such causes as Suicide, Alcohol consumption, and Drug accidental overdose. In particular, opioid-related deaths have increased dramatically across the U.S. during this period. For a systemic analysis of the temporal and spatial patterns of this critical phenomenon from the perspective of public health, we studied it in the context of Appalachian Region (AR), which spans across 13 U.S. states and is home to more than 8 percent of the country's population. We identified 8 spatial and temporal metaclusters of AR counties with relatively high rates of deaths due to the above-mentioned causes over the period 1979-2017 based on U.S. county- and causespecific mortality data. Thus, we analyzed the mortality trends for each of the metaclusters, which were characterized based on their respective demographic and socioeconomic changes.